Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $47.86 / $97.72	Facility	26	$25.70	$47.86	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $302.00	Professional		$93.33	$125.89	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $35.48 / $83.18	Professional	26	$20.89	$35.48	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $218.78	Professional	TC	$67.61	$100.00	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.90 / $79.43	Professional	26	$19.05	$30.90	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $251.19	Professional		$120.23	$190.55	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $38.90 / $56.23	Professional	26	$24.55	$38.90	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $147.91 / $199.53	Professional	TC	$95.50	$147.91	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $380.19	Professional		$123.03	$190.55	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $51.29 / $74.13	Professional	26	$30.20	$51.29	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $147.91 / $309.03	Professional	TC	$87.10	$147.91	$309.03
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $218.78 / $331.13	Professional		$138.04	$218.78	$331.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $44.67 / $66.07	Professional	26	$28.84	$44.67	$66.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $173.78 / $251.19	Professional	TC	$112.20	$173.78	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $173.78 / $354.81	Professional		$91.20	$173.78	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $34.67 / $67.61	Professional	26	$25.70	$34.67	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $141.25 / $275.42	Professional	TC	$67.61	$141.25	$275.42
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $19.05 / $19.05	Facility	26	$16.22	$19.05	$19.05